W. Saeger et K. Reinhard, FAT-CELL METAPLASIA IN THE ADRENAL-CORTEX - INCIDENCE, STRUCTURE, ANDCORRELATION TO BASIC DISEASES IN A POSTMORTEM SERIES, Endocrine pathology, 9(3), 1998, pp. 241-247
In a postmortem series of adrenals from 497 patients 25 cases (5%) sho
wed foci of fat-cell metaplasia or bone-marrow metaplasia in the zona
fasciculata or the zona reticularis. There was only one focus in 4.5%
of adrenals with metaplasia, but in 36.4%, more than six foci were pre
sent. The sizes varied between 0.036 and 0.64 mm. The foci were compos
ed of mature, mostly univacuolar, fat cells and various amounts of mye
loid cells. The incidence of fat-cell metaplasia or of bone marrow met
aplasia correlated with arterial hypertension and severe coronary hear
t disease. In 76% of cases, nodular hyperplasia was demonstrable, but
the metaplasia were more often found adjacent to, rather than within,
the nodules. They appear to be related to metaplasia in adrenocortical
tumors and to myelolipomas. The common pathogenesis is thought to be
based on focal necroses in combination with local endocrine stimulatio
n.